| Doctor Name: | MS. KATHLEEN MARY THALER |
| NPI Number: | 1033464854 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 337465 |
| Business Practice Address: | 21 Edward J. Lempka Drive Florida, NY - 10921 |
| Business Phone Number: | 8453413837 |
| Business Fax Number: | |
| Mailing Address: | Po Box 265, 44 Shore Drive BLOOMING GROVE |
| State: | NY |
| Postal Code: | 10914 |
| Phone Number: | 8454961310 |
| Fax Number: | |
| NPI Enumeration Date: | 07/18/2012 |
| NPI Last Update Date: | 01/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 337465 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |